We have all been guilty of making ineffective presentations at some point in our career. In this article we explore the key principles behind "Presentation Zen," an approach intended to decrease cognitive overload, make presentations more visual, natural, and unique; as well as improve the overall impact of our presentations by allowing the listener to process the information while listening to the presenter.The purpose of this retrospective study was to evaluate the correlation of maxillomandibular advancement (MMA) and airway volume changes in patients with obstructive sleep apnea (OSA), and to determine the surgical skeletal movements necessary to achieve an increase in total airway volume (TAV) of ≥70%. Thirty patients with OSA treated by MMA were evaluated. Pre- and postoperative cone beam computed tomography images were used to determine the horizontal distance and angular changes in surgical parameters and linear, area, and volumetric airway parameters. Postoperatively, the horizontal distance of surgical parameters (A-point, UI, B-point, pogonion, and menton) and craniofacial angulation (SNA and SNB) increased significantly, similar to total surface area, TAV, and minimum cross-sectional area of the airway (p less then 0.0001). The total airway length decreased significantly (p less then 0.0001). The mean increase in TAV was 67.2%. There were positive correlations between linear surgical changes and the percentage change in TAV. https://www.selleckchem.com/products/ABT-263.html All surgical parameters were predictive of a change in TAV ≥70%. The optimal surgical change was 6mm for A-point, 7.9mm for UI, 7.6mm for B-point, 11.2mm for pogonion, and 10mm for menton. In conclusion, maxillary advancement of less than 10mm was adequate in this study to obtain an increase in the TAV of at least 70%.An increased risk of upper airway obstruction (UAO) is seen in up to 95% of patients with facial dysostosis. Secondary to respiratory problems are feeding difficulties and increased nutritional requirements. Little has been described regarding these outcomes in this patient population. Hence, a retrospective cohort study was performed to gather data on functional outcomes. Eighteen patients with facial dysostosis and severe UAO were included. The median follow-up time was 3.42 years. A tracheostomy tube was placed in 13 patients, of whom 10 subsequently underwent mandibular distraction. Three of the five patients without a tracheostomy underwent mandibular distraction as the primary surgical treatment; the remaining two patients were treated conservatively with oxygen supplementation. At presentation, 13 patients had feeding difficulties. Overall malnutrition was present in 16 patients during follow-up. At the end of follow-up, severe UAO was present in 12 patients, feeding difficulties in seven patients, and malnutrition in four patients, while two patients died. In conclusion, patients with facial dysostosis have a high prevalence of severe UAO, feeding difficulties, and malnutrition. Importantly, mandibular distraction has limited success in treating severe UAO in these patients. Close follow-up by a specialized craniofacial team is of paramount importance to manage the long-term consequences.Correlating in-brain pH fluctuations with the pathophysiology has been impeded by the lack of in vivo techniques to precisely determine local pH changes. Here, we developed an all-in-one pH probe for spatially-resolved and label-free pH sensing in vivo, based on a field-effect pH sensor, i.e., a light-addressable potentiometric sensor (LAPS), coupled to a flexible multimodal fiber. A readout photocurrent from the LAPS, elicited from a modulated light source, registers the localized surface potential change, proportional to the pH change. Upon simultaneous illuminations at multi-spot by a plurality of light sources with different modulation frequencies, pH changes at multiple designated spots are obtained via demultiplexing this photocurrent. To enable its in vivo applications, we combined the LAPS with a multimodal fiber fabricated by the convergence thermal drawing. Such fiber seamlessly integrates a multicore optical waveguide in the center for the light delivery, surrounded by electrodes for leading out photocurrent and serving as a pseudo-reference electrode, respectively. Such hybrid all-in-one pH probes can measure pH changes at 14 pixels simultaneously with a spatial resolution of 250 μm and a temporal resolution of 30 Hz. The pH sensitivity was characterized as 57.5 ± 2.2 mV/pH homogeneously across all measurable pixels. Such probes have been implanted into the hippocampal formation of rats and their capabilities to capture pH changes at multiple pixels were evaluated at both physiological and pathological conditions. Technologies developed here represents a new class of in vivo chemical sensing technologies enabling the spatially-resolved investigation of intrinsic chemical signals in deep brain structures with high spatial and temporal resolutions.
To develop parsimonious German scales (CollaboRATE
) to assess shared decision making (SDM) with patients aged 7-18 years, parents and parents on behalf of their children (parent-proxy reports), and to establish comprehensibility and preliminary face validity.
Based on an existing SDM scale for adults (CollaboRATE) we developed CollaboRATE
in a two-step approach (1) team-based translation of the English CollaboRATE scale into German and adaptation for pediatric patients, parents and parent-proxy reports, followed by (2) iterative revisions of the CollaboRATE
scales based on cognitive interviews with patients and parents until comprehensibility and preliminary face validity were established.
Taking into account seven problem areas identified in four rounds of cognitive interviews (e.g., item complexity) we developed CollaboRATE
scales for patients, parents and parent-proxy reports. By iteratively revising items we were able to resolve all problem areas and achieved full comprehensibility and intended interpretation of all items.
The scales enable the parsimonious assessment of SDM with pediatric patients and parents as well as comparisons between the two groups. Future empirical work will establish the psychometric performance of CollaboRATE
.
CollaboRATE
can be used in quality improvement initiatives to foster the comprehensive implementation of SDM in pediatrics.
CollaboRATEpediatric can be used in quality improvement initiatives to foster the comprehensive implementation of SDM in pediatrics.
We have all been guilty of making ineffective presentations at some point in our career. In this article we explore the key principles behind "Presentation Zen," an approach intended to decrease cognitive overload, make presentations more visual, natural, and unique; as well as improve the overall impact of our presentations by allowing the listener to process the information while listening to the presenter.The purpose of this retrospective study was to evaluate the correlation of maxillomandibular advancement (MMA) and airway volume changes in patients with obstructive sleep apnea (OSA), and to determine the surgical skeletal movements necessary to achieve an increase in total airway volume (TAV) of ≥70%. Thirty patients with OSA treated by MMA were evaluated. Pre- and postoperative cone beam computed tomography images were used to determine the horizontal distance and angular changes in surgical parameters and linear, area, and volumetric airway parameters. Postoperatively, the horizontal distance of surgical parameters (A-point, UI, B-point, pogonion, and menton) and craniofacial angulation (SNA and SNB) increased significantly, similar to total surface area, TAV, and minimum cross-sectional area of the airway (p less then 0.0001). The total airway length decreased significantly (p less then 0.0001). The mean increase in TAV was 67.2%. There were positive correlations between linear surgical changes and the percentage change in TAV. https://www.selleckchem.com/products/ABT-263.html All surgical parameters were predictive of a change in TAV ≥70%. The optimal surgical change was 6mm for A-point, 7.9mm for UI, 7.6mm for B-point, 11.2mm for pogonion, and 10mm for menton. In conclusion, maxillary advancement of less than 10mm was adequate in this study to obtain an increase in the TAV of at least 70%.An increased risk of upper airway obstruction (UAO) is seen in up to 95% of patients with facial dysostosis. Secondary to respiratory problems are feeding difficulties and increased nutritional requirements. Little has been described regarding these outcomes in this patient population. Hence, a retrospective cohort study was performed to gather data on functional outcomes. Eighteen patients with facial dysostosis and severe UAO were included. The median follow-up time was 3.42 years. A tracheostomy tube was placed in 13 patients, of whom 10 subsequently underwent mandibular distraction. Three of the five patients without a tracheostomy underwent mandibular distraction as the primary surgical treatment; the remaining two patients were treated conservatively with oxygen supplementation. At presentation, 13 patients had feeding difficulties. Overall malnutrition was present in 16 patients during follow-up. At the end of follow-up, severe UAO was present in 12 patients, feeding difficulties in seven patients, and malnutrition in four patients, while two patients died. In conclusion, patients with facial dysostosis have a high prevalence of severe UAO, feeding difficulties, and malnutrition. Importantly, mandibular distraction has limited success in treating severe UAO in these patients. Close follow-up by a specialized craniofacial team is of paramount importance to manage the long-term consequences.Correlating in-brain pH fluctuations with the pathophysiology has been impeded by the lack of in vivo techniques to precisely determine local pH changes. Here, we developed an all-in-one pH probe for spatially-resolved and label-free pH sensing in vivo, based on a field-effect pH sensor, i.e., a light-addressable potentiometric sensor (LAPS), coupled to a flexible multimodal fiber. A readout photocurrent from the LAPS, elicited from a modulated light source, registers the localized surface potential change, proportional to the pH change. Upon simultaneous illuminations at multi-spot by a plurality of light sources with different modulation frequencies, pH changes at multiple designated spots are obtained via demultiplexing this photocurrent. To enable its in vivo applications, we combined the LAPS with a multimodal fiber fabricated by the convergence thermal drawing. Such fiber seamlessly integrates a multicore optical waveguide in the center for the light delivery, surrounded by electrodes for leading out photocurrent and serving as a pseudo-reference electrode, respectively. Such hybrid all-in-one pH probes can measure pH changes at 14 pixels simultaneously with a spatial resolution of 250 μm and a temporal resolution of 30 Hz. The pH sensitivity was characterized as 57.5 ± 2.2 mV/pH homogeneously across all measurable pixels. Such probes have been implanted into the hippocampal formation of rats and their capabilities to capture pH changes at multiple pixels were evaluated at both physiological and pathological conditions. Technologies developed here represents a new class of in vivo chemical sensing technologies enabling the spatially-resolved investigation of intrinsic chemical signals in deep brain structures with high spatial and temporal resolutions.
To develop parsimonious German scales (CollaboRATE
) to assess shared decision making (SDM) with patients aged 7-18 years, parents and parents on behalf of their children (parent-proxy reports), and to establish comprehensibility and preliminary face validity.
Based on an existing SDM scale for adults (CollaboRATE) we developed CollaboRATE
in a two-step approach (1) team-based translation of the English CollaboRATE scale into German and adaptation for pediatric patients, parents and parent-proxy reports, followed by (2) iterative revisions of the CollaboRATE
scales based on cognitive interviews with patients and parents until comprehensibility and preliminary face validity were established.
Taking into account seven problem areas identified in four rounds of cognitive interviews (e.g., item complexity) we developed CollaboRATE
scales for patients, parents and parent-proxy reports. By iteratively revising items we were able to resolve all problem areas and achieved full comprehensibility and intended interpretation of all items.
The scales enable the parsimonious assessment of SDM with pediatric patients and parents as well as comparisons between the two groups. Future empirical work will establish the psychometric performance of CollaboRATE
.
CollaboRATE
can be used in quality improvement initiatives to foster the comprehensive implementation of SDM in pediatrics.
CollaboRATEpediatric can be used in quality improvement initiatives to foster the comprehensive implementation of SDM in pediatrics.
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